Abstract In this paper the author argues that trans‐identification and its associated medical treatment can constitute an attempt to evade experiences of psychological distress. This occurs on three levels. Firstly, the trans person themselves may seek to evade dysregulated affects associated with such experiences as attachment trauma, childhood abuse, and ego‐alien sexual feelings. Secondly, therapists may attempt to evade feelings, such as fear and hatred, evoked by engaging with these dysregulated affects. Thirdly, we, as a society, may wish to evade acknowledging the reality of such trauma, abuse and sexual distress by hypothesizing that trans‐identification is a biological issue, best treated medically. The author argues that the quality of evidence supporting the biomedical approach is extremely poor. This puts young trans people at risk of receiving potentially damaging medical treatment they may later seek to reverse or come to regret, while their underlying psychological issues remain unaddressed.

中文翻译：

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跨性别医学化和逃避心理困扰的尝试

摘要 在本文中，作者认为跨身份及其相关的医疗可以构成逃避心理困扰体验的尝试。这发生在三个层面。首先，跨性别者自己可能会寻求逃避与依恋创伤、童年虐待和自我异己的性感受等经历相关的失调影响。其次，治疗师可能会试图逃避因参与这些失调的情绪而引起的感觉，例如恐惧和仇恨。第三，作为一个社会，我们可能希望通过假设跨身份识别是一个生物学问题，最好通过医学治疗来逃避承认这种创伤、虐待和性困扰的现实。作者认为，支持生物医学方法的证据质量极差。